Job Information
UnitedHealth Group Clinical Quality Consultant II - Midland-Odessa, TX in Midland, Texas
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start C aring. Connecting. Growing together.
The Clinical Quality Consultant II (CQC) will drive consistency, efficient processes and share best practices, in a collaborative effort with the providers, designed to facilitate a minimum 4 STAR performance. The CQC will participate in quality improvement initiatives, attend monthly or joint operating committee meetings, develop recommendations for quality remediation plans and create tools and databases to capture relevant data for each region. This position will work collaboratively with each regional/market team and their leadership in a matrix relationship.
Primary Responsibilities:
Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher
Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
Be the primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which includes
Quality corporate operations and Regional/Market operations.
Lead or participate and present in weekly, Monthly, Bi-monthly, Quarterly and/or Annual business Review meetings related to STAR activities which summarize provider group performance and market performance as requested by or required by Quality or Regional leadership
Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes
Focus communications and efforts accordingly
Develop solution-based, user friendly initiatives to support practice success
Performs all other related duties as assigned
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
2+ years of Healthcare/Health Plan experience
2+ years of HEDIS experience and/or knowledge
Proven solid data management and/or project management skills
Proven solid knowledge of managed care requirements related to clinical quality
Solid proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
Demonstrated ability to assist with focusing activities toward a strategic direction and achieve targets
Proven excellent team development skills
Proven solid interpersonal skills
Proven excellent time management and prioritization skills
Proven excellent written and verbal communications skills
Preferred Qualifications:
Significant Clinical and/or Health Education experience
Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)
Experienced in medical record review
Proficiency with Microsoft Windows Suite (PPT, Excel, Word, Visio)
Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma, Lean, and/or PDSA
Physical & Mental Requirement:
- Ability to push or pull heavy objects using pounds of force
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
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